Coding Specialist II
Parkland Health, Dallas, TX, United States
Primary Purpose
The Primary Purpose of the Coding Specialist II is to code and verify charge data necessary to ensure correct coding, abstracting and billing on emergency department (ED), same day surgery (SDS), outpatient clinic (OPC), observation (OBS), specialty clinics and/or inpatient OB/newborn encounters. This role is also responsible for charge review on clinic and hospital visits to ensure accurate professional charging and billing. This position requires the coder to be highly proficient in the proper assignment of ICD‑10 CM, PCS, CPT, HCPCS, HCC, HEDIS CAT II, E/M and modifier codes. The coder demonstrates the ability to provide direction to coding staff regarding coding integrity, established coding guidelines and Parkland’s policies to ensure accuracy of recorded patient medical information and appropriate reimbursement for services rendered.
Minimum Specifications
High school diploma required.
Must have successfully completed an approved coding program.
OR must be a graduate of a health information management program.
Must have strong knowledge of anatomy and physiology and possess strong application skills.
Experience
Must have two (2) years of coding experience in an acute care setting or diverse clinical specialties.
Physician office coding, charging and billing experience preferred.
Equivalent Education And/Or Experience
May have an equivalent combination of education and/or experience in lieu of specific education and/or experience as stated above.
Certification/Registration/Licensure
Because of the lag in SCCE, HCCA, NCRA, and AHIMA updating the status of certifications, current employees whose certification is granted through one of these associations are allowed up to seven (7) calendar days, after expiration, to provide proof of renewal. Although an additional seven (7) calendar days is allowed to provide proof of renewal, there cannot be a lapse in the certification’s ‘active’ status.
Must be certified through the American Health Information Management Association (AHIMA) as one of the following:
Registered Health Information Management Technician (RHIT)
Registered Health Information Management Administrator (RHIA)
Certified Coding Specialist (CCS)
Certified Coding Specialist Physician Based (CCS‑P)
Certified Coding Associate (CCA)
OR must be certified through the American Association of Procedural Coders (AAPC) as one of the following:
Certified Professional Coder (CPC)
Certified Professional Coder‑Hospital (CPC‑H)
Certified Outpatient Coder (COC)
Required Tests For Placement
Score a minimum of 80% on a pre‑employment inpatient/outpatient coding test. Contract coders with a proven coding accuracy rate of 95% at Parkland Health and Hospital System are exempt from this requirement.
Skills Or Special Abilities
Advance coding and charge review skills understanding the utilization of modifiers and other coding, charging and billing rules to include AMA and other state and federal organizations.
Advanced knowledge of ICD‑9/ICD‑10‑CM/PCS, CPT‑4/HCPCS, HCC and HEDIS CAT II, E/M coding and abstracting, APC classification and reimbursement structures, applicable coding edits and general knowledge of local coverage for hospital and professional billing.
Score a minimum of 80% on a pre‑employment coding test. Contract coders with a proven coding accuracy rate of 95% at Parkland Health and Hospital System are exempt from this requirement.
Must have knowledge of medical terminology, the human disease process, anatomy and physiology.
Demonstrate proficiency in coding and encoder skills.
Demonstrate knowledge of computer software applications including MS Office and computer assisted coding (CAC).
Knowledge of Epic EHR and 3M 360 coding and abstracting software is preferred.
Responsibilities
Code, abstract and conduct charge quality review on all episodes of care on ED, SDS, OPC, OBS and/or inpatient OB/newborn hospital and specialty clinic encounters according to coding conventions, guidelines and hospital policy, analyzing questionable documentation to ensure accuracy of information and resolving identified issues.
Assign appropriate diagnosis and procedure codes utilizing ICD‑10‑CM/PCS, CPT, HCPCS, HCC and HEDIS CAT II, E/M codes according to CMS requirements for both professional and hospital billing. May assist in training and reviewing the work of other coders for accuracy and efficiency.
Achieve and maintain 95% accuracy on quality reviews and assigned productivity standards.
May verify, edit and/or enter charges based on documentation or payer/billing requirements reporting any discrepancies in a timely manner.
Update patient database with classification codes and resolve conflicts or inconsistencies to provide sufficient patient health information according to Parkland’s standards.
Stay abreast of the latest developments, advancements, and trends in the field of health information management by attending workshops, reading professional journals, actively participating in professional organizations, and integrating knowledge gained into current work practices.
Identify ways to improve work processes and improve customer satisfaction. Make recommendations to supervisor, implement, and monitor results as appropriate in support of the overall goals of the department and Parkland.
Facilitate a positive working relationship with physicians, nurses, and medical staff and hospital employees to ensure that all work‑related encounters are productive.
Maintain knowledge of applicable rules, regulations, policies, laws and guidelines that impact the coding area. Develop effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and federal, state, and private health plans. Seek advice and guidance as needed to ensure proper understanding.
Maintain CE hours and renew annual coding credentials.
Routine screenings/proof of immunizations exclusions: Virtual workforce employees are not required to undergo routine screening for communicable diseases including TB, the flu vaccination, or the COVID‑19 vaccination.
Job Accountabilities
Identify ways to improve work processes and improve customer satisfaction. Make recommendations to supervisor, implement, and monitor results as appropriate in support of the overall goals of the department and Parkland.
Stay abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and maintaining certification or licensure. Integrate knowledge gained into current work practices.
Maintain knowledge of applicable rules, regulations, policies, laws and guidelines that impact the area. Develop effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and federal, state, and private health plans. Seek advice and guidance as needed to ensure proper understanding.
Requisition ID:
985895
#J-18808-Ljbffr
Minimum Specifications
High school diploma required.
Must have successfully completed an approved coding program.
OR must be a graduate of a health information management program.
Must have strong knowledge of anatomy and physiology and possess strong application skills.
Experience
Must have two (2) years of coding experience in an acute care setting or diverse clinical specialties.
Physician office coding, charging and billing experience preferred.
Equivalent Education And/Or Experience
May have an equivalent combination of education and/or experience in lieu of specific education and/or experience as stated above.
Certification/Registration/Licensure
Because of the lag in SCCE, HCCA, NCRA, and AHIMA updating the status of certifications, current employees whose certification is granted through one of these associations are allowed up to seven (7) calendar days, after expiration, to provide proof of renewal. Although an additional seven (7) calendar days is allowed to provide proof of renewal, there cannot be a lapse in the certification’s ‘active’ status.
Must be certified through the American Health Information Management Association (AHIMA) as one of the following:
Registered Health Information Management Technician (RHIT)
Registered Health Information Management Administrator (RHIA)
Certified Coding Specialist (CCS)
Certified Coding Specialist Physician Based (CCS‑P)
Certified Coding Associate (CCA)
OR must be certified through the American Association of Procedural Coders (AAPC) as one of the following:
Certified Professional Coder (CPC)
Certified Professional Coder‑Hospital (CPC‑H)
Certified Outpatient Coder (COC)
Required Tests For Placement
Score a minimum of 80% on a pre‑employment inpatient/outpatient coding test. Contract coders with a proven coding accuracy rate of 95% at Parkland Health and Hospital System are exempt from this requirement.
Skills Or Special Abilities
Advance coding and charge review skills understanding the utilization of modifiers and other coding, charging and billing rules to include AMA and other state and federal organizations.
Advanced knowledge of ICD‑9/ICD‑10‑CM/PCS, CPT‑4/HCPCS, HCC and HEDIS CAT II, E/M coding and abstracting, APC classification and reimbursement structures, applicable coding edits and general knowledge of local coverage for hospital and professional billing.
Score a minimum of 80% on a pre‑employment coding test. Contract coders with a proven coding accuracy rate of 95% at Parkland Health and Hospital System are exempt from this requirement.
Must have knowledge of medical terminology, the human disease process, anatomy and physiology.
Demonstrate proficiency in coding and encoder skills.
Demonstrate knowledge of computer software applications including MS Office and computer assisted coding (CAC).
Knowledge of Epic EHR and 3M 360 coding and abstracting software is preferred.
Responsibilities
Code, abstract and conduct charge quality review on all episodes of care on ED, SDS, OPC, OBS and/or inpatient OB/newborn hospital and specialty clinic encounters according to coding conventions, guidelines and hospital policy, analyzing questionable documentation to ensure accuracy of information and resolving identified issues.
Assign appropriate diagnosis and procedure codes utilizing ICD‑10‑CM/PCS, CPT, HCPCS, HCC and HEDIS CAT II, E/M codes according to CMS requirements for both professional and hospital billing. May assist in training and reviewing the work of other coders for accuracy and efficiency.
Achieve and maintain 95% accuracy on quality reviews and assigned productivity standards.
May verify, edit and/or enter charges based on documentation or payer/billing requirements reporting any discrepancies in a timely manner.
Update patient database with classification codes and resolve conflicts or inconsistencies to provide sufficient patient health information according to Parkland’s standards.
Stay abreast of the latest developments, advancements, and trends in the field of health information management by attending workshops, reading professional journals, actively participating in professional organizations, and integrating knowledge gained into current work practices.
Identify ways to improve work processes and improve customer satisfaction. Make recommendations to supervisor, implement, and monitor results as appropriate in support of the overall goals of the department and Parkland.
Facilitate a positive working relationship with physicians, nurses, and medical staff and hospital employees to ensure that all work‑related encounters are productive.
Maintain knowledge of applicable rules, regulations, policies, laws and guidelines that impact the coding area. Develop effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and federal, state, and private health plans. Seek advice and guidance as needed to ensure proper understanding.
Maintain CE hours and renew annual coding credentials.
Routine screenings/proof of immunizations exclusions: Virtual workforce employees are not required to undergo routine screening for communicable diseases including TB, the flu vaccination, or the COVID‑19 vaccination.
Job Accountabilities
Identify ways to improve work processes and improve customer satisfaction. Make recommendations to supervisor, implement, and monitor results as appropriate in support of the overall goals of the department and Parkland.
Stay abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and maintaining certification or licensure. Integrate knowledge gained into current work practices.
Maintain knowledge of applicable rules, regulations, policies, laws and guidelines that impact the area. Develop effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and federal, state, and private health plans. Seek advice and guidance as needed to ensure proper understanding.
Requisition ID:
985895
#J-18808-Ljbffr